Journal of clinical monitoring and computing
-
J Clin Monit Comput · Dec 2022
Clinical TrialFeasibility of non-invasive neuromonitoring in general intensive care patients using a multi-parameter transcranial Doppler approach.
To assess the feasibility of Transcranial Doppler ultrasonography (TCD) neuromonitoring in a general intensive care environment, in the prognosis and outcome prediction of patients who are in coma due to a variety of critical conditions. ⋯ Preliminary results from the trial indicate that multi-parameter TCD neuromonitoring increases outcome-predictive power and TCD-based indices can be applied to general intensive care monitoring.
-
J Clin Monit Comput · Dec 2022
Prediction of sepsis onset in hospital admissions using survival analysis.
To determine the efficacy of modern survival analysis methods for predicting sepsis onset in ICU, emergency, medical/surgical, and TCU departments. We performed a retrospective analysis on ICU, med/surg, ED, and TCU cases from multiple Mercy Health hospitals from August 2018 to March 2020. Patients in these departments were monitored by the Mercy Virtual vSepsis team and sepsis cases were determined and documented in the Mercy EHR via a rule-based engine utilizing clinical data. ⋯ This methodology improves upon previous work by demonstrating excellent model performance when generalizing survival-based prediction methods to both severe sepsis and septic shock as well as non-ICU departments. IRB InformationTrial Registration ID: 1,532,327-1. Trial Effective Date: 12/02/2019.
-
J Clin Monit Comput · Dec 2022
Comment LetterBesdata Video Laryngeal Mask (BD-VLM)- a New Vision-Incorporated 3rd Generation Video Laryngeal Mask Airway : Dear editor.
Since the recent editorial 2, we were approached to evaluate another video laryngeal mask airway - the Besdata Video Laryngeal Mask (BD-VLM) TM, which has a different design concept, specifications and characteristics (Figure 1) compared to the other two.
-
J Clin Monit Comput · Dec 2022
Prospective validation of gas man simulations of sevoflurane in O2/air over a wide fresh gas flow range.
The use of inhaled anesthetics has come under increased scrutiny because of their environmental effects. This has led to a shift where sevoflurane in O2/air has become the predominant gas mixture to maintain anesthesia. To further reduce environmental impact, lower fresh gas flows (FGF) should be used. ⋯ During the first 15 min, MDPE and MDAPE were 7% [- 6, 28] and 13% [6, 32], respectively, and during the last 45 min - 1% [- 5, 5] and 5% [2, 9], respectively. In conclusion, Gas Man® predicts FETsevo in O2/air in adults over a wide range of FGF and vaporizer settings using different workstations with both MDPE and MDAPE < 10% during the first hour of anesthesia, with better relative performance for simulating maintenance than wash-in. In the authors' opinion, this degree of performance suffices for Gas Man® to be used to quantify the environmental impact of FGF reduction in real life practice of the wash-in and maintenance period combined.
-
J Clin Monit Comput · Dec 2022
Accuracy of a point-of-care blood lactate measurement device in a prehospital setting.
Point-of-care blood lactate is a promising prognostic biomarker of short-term mortality risk. Portable lactate meters need validation in the prehospital setting before widespread implementation and it is unknown whether the mode of sampling (arterial, capillary or venous) matters. This study aims to compare the StatStrip Xpress Lactate Meter's (SSX) accuracy to a validated blood gas analyser, ABL90 FLEX (ABL90), in arterial samples in the prehospital environment and to determine if lactate levels measured in venous and capillary blood samples are sufficiently accurate compared to arterial lactate levels. ⋯ Bland-Altman plots showed that SSX lactate measurements in arterial, venous and capillary blood samples all had systematically negative biases compared to ABL90. We conclude that the SSX is accurate in our prehospital setting. Venous samples should be preferred over capillary samples, when arterial samples cannot be obtained.